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The Australian Commission for Safety and Quality in Health Care has created the National Safety and Quality Health Service standards that all hospitals must address in order to remain accredited. This case study details the first known digitisation of the 10 national quality and safety standards mandated in a quaternary integrated digital hospital. A team of clinical informaticians, information technology experts and clinicians was assembled. Data were chosen and the data were then extracted and validated and presented (often in near real time) in an easily consumable dashboard format with appropriate governance to allow clinicians and executives to monitor the quality and safety standards across the hospital. All 10 standards were defined and extracted contemporaneously from the digital hospital for every patient, every time. This is in stark contrast with traditional retrospective point prevalence surveys. This case study details the first known fully digital accreditation in a sophisticated integrated digital hospital. Digitisation of hospital quality and safety to produce real-time data is the future of clinical redesign to improve patient care. What is known about the topic?: Healthcare delivery is complex and the ability of healthcare providers to maintain consistent standards of quality and safety is variable. Traditionally, these standards have been assessed by intermittent retrospective point-prevalence survey activity. Sophisticated digital hospitals provide the opportunity to develop data and analytics that monitor quality and safety standards across every patient, every time in near real time. What does this paper add?: This paper describes a digital hospital which has created streaming analytics to monitor live performance of quality and safety standards. The necessary skills, leadership and governance for this process are outlined and the products described. What are the implications for practitioners?: Shifting from retrospective paper-based point prevalence surveys to a digital platform has several implications. Firstly, it is an imperative to drive digital transformation of Australian hospitals. Secondly, it provides data for intervention to the hospital staff, so that issues can be addressed and improved in real-time, rather than waiting for survey results. Lastly, this new model of maintaining quality and safety also requires the development of new skills in the hospital setting including data literacy, digital clinical governance and clinical informatics. [ABSTRACT FROM AUTHOR]

Objectives. The aim of this study was to examine patient perceptions regarding vascular access quality measurement. Methods. A web-based, cross-sectional survey was performed using a convenience sample of healthcare consumers with vascular access experience, recruited from September 2019 to June 2020. Survey respondents were asked to rate the perceived importance of 50 vascular access data items, including patient demographics, clinical and device characteristics, and insertion, management and complication data. Data were ranked using a five-point Likert scale (1, least important; 5, most important), and are reported as median values. Respondents proposed additional items and explored broader perspectives using free-text responses, which were analysed using inductive thematic analysis. Results. In all, 68 consumers completed the survey. Participants were primarily female (82%), aged 40-49 years (29%) and living in Australia or New Zealand (84%). All respondents indicated that measuring the quality of vascular access care was important. Of the 50 items, 37 (74%) were perceived as 'most important' (median score 5), with measures of quality (i.e. outcomes and complications) rated highly (e.g. thrombosis and primary blood stream infection). Participants proposed 16 additional items. 'Gender' received the lowest perceived importance score (median score 3). Two themes emerged from the qualitative analysis of broader perspectives: (1) measurement of vascular access device complication severity and associated factors; and (2) patient experience. Conclusion. Measuring vascular access quality and safety is important to consumers. Outcome and complication measures were rated 'most important', with respondents identifying a need for increased monitoring of their overall vascular access journey through the health system. [ABSTRACT FROM AUTHOR]

Digital transformation of Australian hospitals is occurring rapidly. Although the clinical community has had limited ability to influence high-level decision making and investments into digital health technologies, as these technologies increasingly transform the way patients are cared for, the clinical community must influence the digital health agenda and be an integral part of the decision-making process. This case study details the process and lessons learnt during the development of the state-wide consensus statement detailing the clinical requirements for digital health initiatives to form the Queensland Digital Health Clinical Charter. To the best of our knowledge, Queensland is the first Australian jurisdiction to create a Digital Clinical Charter to be specifically referenced in the investment in and governance of digital health in hospitals. By developing this clinical charter for digital health, and in articulating the needs of clinicians, a clinical framework will be added to both the decision-making process around the investments in digital health and the definition and realisation of the expected benefits from these sizable investments. What is known about the topic?: Digital transformation of healthcare is occurring rapidly. The clinical community has had limited ability to influence high-level decision making and investments into these digital health technologies. Tension currently exists between the clinical community who must use the new digital technologies and the technical groups that govern the introduction of the new technologies. This tension can be manifest as clinicians refusing to adopt new systems, safety concerns and an inability to reach consensus on direction. There are few peer reviewed publications addressing this tension between the clinical community and technical providers. What does this paper add?: This paper is the first attempt to create a list of clinical requirements for digital transformation that crosses professional streams and is endorsed by the state-wide executive leadership team to inform the acquisition and governance of digital health technologies. What are the implications for practitioners?: Clinicians can feel excluded and marginalised during the decision-making process for new digital technologies, despite the fact that they are often using these technologies to deliver hands-on care to patients. This charter clearly articulates the requirements of clinicians for digital transformation and has been endorsed by the executive leadership team of Queensland Health. The charter adds a clinical framework to be referenced during the decision-making process around the investments in digital health, and the definition and realisation of the expected benefits from these sizable investments. As the digital landscape in public hospitals evolves, clinicians are becoming increasingly reliant upon digital technologies. It is critical that clinicians have a strong effect on technology acquisition and governance to maximise the quality and efficiency of the care they provide. [ABSTRACT FROM AUTHOR]